Abstract

Summary

This study based on 306 hip fracture patients admitted to a tertiary care center in Sri Lanka showed higher inpatient (6.1% vs 2.8%) and post-discharge (26% vs 20% at 24 months) mortality among men compared with women. Furthermore, 58% had impaired activities of daily living at 12 months.

Introduction

Data related to the outcome of patients admitted following fragility hip fracture are not found in Sri Lanka. We assessed the mortality and physical dependence of hip fracture survivors in our region.

Methods

All patients admitted with new hip fracture to Teaching Hospital, Karapitiya, Galle, Sri Lanka, during June 2014 to Feb 2015 were followed up for 24 months. Readmissions and old fractures were excluded and patients were followed up during the hospital stay and subsequently for 24 months.

Results

The registry included 309 patients (women = 211) and mean (SD) age of men and women were 75.1 (11.3) and 76.8 (8.9) years, respectively. Majority (n = 285, 92%) had been physically independent and were able to walk indoors unaided prior to fracture. Based on the 10-item Barthel Index, only 37.6% were physically independent (score of 100) at 3 months after discharge. This number increased to 40% at 6 months but 58% had impaired activities of daily living at 12 months, post-fracture. Mortality rates, both inpatient hospital (6.1% vs 2.8%) and post-discharge from hospital (26% vs 20% at 24 months) were higher in men compared with women. Most deaths (66.6% in men and 73.1% in women) occurred within the first 12 months. When compared with age- and sex-matched national mortality rates, at 24 months, the relative risks of death in men and women were 3.4 and 3.7, respectively.

Conclusions

There is an increased risk of death following hip fracture and the risk was higher in the first 12 months compared with the next 12 months. Men had higher crude mortality compared with women and 58% patients had limitations in daily activities at 12 months, post-fracture.